ePrescribing

BACKGROUND: Investment in the implementation of hospital ePrescribing systems has been a priority in many economically-developed countries in order to modernise the delivery of healthcare. However, maximum gains in the safety, quality and efficiency of care are unlikely to be fully realised unless ePrescribing systems are further optimised in a local context. Typical barriers to optimal use are often encountered in relation to a lack of systemic capacity and preparedness to meet various levels of interoperability requirements, including at the data, systems and services levels...

BACKGROUND: Antimicrobial resistance, the ability of microorganisms to survive antimicrobial drugs, is a public health emergency. Although electronic prescribing (ePrescribing)-based interventions designed to reduce unnecessary antimicrobial usage exist, these often do not integrate effectively with existing workflows. As a result, ePrescribing-based interventions may have limited impact in addressing antimicrobial resistance. OBJECTIVE: We sought to understand the existing ePrescribing-based antimicrobial stewardship (AMS) practices in an English hospital preceding the implementation of functionality designed to improve AMS...

BACKGROUND: Antimicrobial resistance is a leading global public health threat, with inappropriate use of antimicrobials in healthcare contributing to its development. Given this urgent need, we developed a complex ePrescribing-based Anti-Microbial Stewardship intervention (ePAMS+). METHODS: ePAMS+ includes educational and organisational behavioural elements, plus guideline-based clinical decision support to aid optimal antimicrobial use in hospital inpatients. ePAMS+ particularly focuses on prompt initiation of antimicrobials, followed by early review once test results are available to facilitate informed decision-making on stopping or switching where appropriate...

OBJECTIVES: The introduction of ePrescribing systems offers the potential to improve the safety, quality and efficiency of prescribing, medication management decisions and patient care. However, an ePrescribing system will require some customisation and configuration to capture a range of workflows in particular hospital settings. This can be part of an optimisation strategy, which aims at avoiding workarounds that lessen anticipated safety and efficiency benefits. This paper aims to identify ePrescribing optimisation strategies that can be translated into hospitals in different national settings...

INTRODUCTION: A National Cancer Information System is planned for phased implementation in Irish cancer centres to enable electronic prescribing (ePrescribing) of systemic anti-cancer therapy. This study aimed to capture the opinions of healthcare professionals in a hospital setting relating to the current paper-based workflow for systemic anti-cancer therapy prescribing and their attitudes and expectations of the new ePrescribing system to develop recommendations, which assist in the planning and implementation of future ePrescribing systems...

Education and training in prescribing for medical student often relies on the use of paper drug charts. With the pending elimination of paper prescribing in UK hospitals we look to address how educators can introduce eprescribing into medical undergraduate teaching of prescribing skills.

PURPOSE: The Association of American Medical Colleges has delineated 13 Entrustable Professional Activities (EPAs) that entering residents should be expected to perform on day 1 of residency without direct supervision. EPA4, Enter and discuss orders and prescriptions, describes an activity that all recent medical graduates (Interns) spend a great deal of time daily on. Additionally, with the ever-increasing numbers of pharmaceuticals and biologics, there is a need for clinical pharmacology education in the curriculum to help students achieve EPA4...

Purpose: We evaluated physician prescribing patterns before and after the implementation of a state-mandated opioid electronic prescribing (ePrescribing) program after 4 common outpatient hand surgeries. Specifically, we aimed to answer the following: (1) is there a change in the number of opioids prescribed after the institution of ePrescribing for carpal tunnel release (CTR), ganglion excision, distal radius fracture (DRF) open reduction internal fixation (ORIF), and carpometacarpal (CMC) arthroplasty and (2) what factors are associated with an increased number of tablets or total morphine milligram equivalents (MMEs) prescribed...

Objective: Electronic prescribing systems offer considerable opportunities to enhance the safety, effectiveness and efficiency of prescribing and medicines management decisions but, despite considerable investments in health IT infrastructure and healthcare professional training, realising these benefits continues to prove challenging. How systems are customised and configured to achieve optimal functionality is an increasing focus for policymakers. We sought to develop an overview of the policy landscape currently supporting optimisation of hospital ePrescribing systems in economically developed countries with a view to deriving lessons for the United Kingdom (UK)...

INTRODUCTION: COVID-19 has caused millions of hospitalisations and deaths globally. A range of vaccines have been developed and are being deployed at scale in the UK to prevent SARS-CoV-2 infection, which have reduced risk of infection and severe COVID-19 outcomes. Those with COVID-19 are now being treated with several repurposed drugs based on evidence emerging from recent clinical trials. However, there is currently limited real-world data available related to the use of these drugs in routine clinical practice...

INTRODUCTION: Electronic prescribing (ePrescribing) is a key area of development and investment in the UK and across the developed world. ePrescribing is widely understood as a vehicle for tackling medication-related safety concerns, improving care quality and making more efficient use of health resources. Nevertheless, implementation of an electronic health record does not itself ensure benefits for prescribing are maximised. We examine the process of optimisation of ePrescribing systems using case studies to provide policy recommendations based on the experiences of digitally mature hospital sites...

BACKGROUND: Health information technology (HIT) is known to reduce prescribing errors but may also cause new types of technology-generated errors (TGE) related to data entry, duplicate prescribing, and prescriber alert fatigue. It is unclear which component behaviour change techniques (BCTs) contribute to the effectiveness of prescribing HIT implementations and optimisation. This study aimed to (i) quantitatively assess the HIT that reduces prescribing errors in hospitals and (ii) identify the BCTs associated with effective interventions...

Improving antimicrobial prescribing is a difficult process often requiring labour-intensive, multi-modal interventions. Many hospitals have introduced ePrescribing systems but the effect on antimicrobial prescribing, without treatment choice decision support systems, has not been well described. We sought to determine whether the introduction of ePrescribing improved prescribing quality. Patient records for inpatients on four rehabilitation wards, two using ePrescribing and two using the National Medication Chart, during February 2017, were retrospectively reviewed to identify all antimicrobial prescriptions, which were then reviewed for quality...

INTRODUCTION: Electronic prescribing (ePrescribing) systems can improve the quality of prescribing decisions and substantially reduce the risk of serious medication errors in hospitals. However, realising these benefits depends on ensuring that relevant sociotechnical considerations are addressed. Optimising ePrescribing systems is essential to maximise the associated benefits and minimise the accompanying risks of these large-scale and expensive health informatics infrastructures. METHODS: We will undertake a systematic scoping review of the literature to identify strategies to achieve optimisation of ePrescribing systems...

BACKGROUND: Several benefits and problems of electronic prescribing (ePrescribing) are described in scientific literature, though problems remain in the implementation. In this study, we evaluated the pharmacist's perception of the ePrescription implementation within the community pharmacy software in Belgium, and the frequency and hindrance of encountered problems. MATERIAL AND METHODS: A cross-sectional study was conducted among community pharmacists in Belgium to measure satisfaction with the ePrescribing implementation and factors influencing this satisfaction...

Belgium is in a transition phase from paper-based prescriptions to electronic prescriptions (ePrescriptions) during which both the paper and electronic format are valid. Since patients still get a paper proof of the ePrescription, sometimes pharmacists use the ePrescription as paper-based prescription. When the government demands a complete dematerialization, i.e. no more paper-based prescriptions, this will no longer be possible. Therefore, we questioned the frequency and reasons for treating an ePrescription as paper-based...

BACKGROUND: Electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of health services, but the translation of this into reduced harm for patients remains unclear. This review aimed to synthesise primary qualitative research relating to how stakeholders experience the adoption of ePrescribing/CPOE systems in hospitals, to help better understand why and how healthcare organisations have not yet realised the full potential of such systems and to inform future implementations and research...

Objective This study aims to assist hospitals contemplating digital transformation by assessing the reported qualitative effects of rapidly implementing an integrated eHealth system in a large Australian hospital and determining whether existing literature offers a reliable framework to assess the effects of digitisation. Methods A qualitative, single-site case study was performed using semistructured interviews supplemented by focus groups, observations and documentation. In all, 92 individuals across medical, nursing, allied health, administrative and executive roles provided insights into the eHealth system, which consisted of an electronic medical record, computerised decision support, computerised physician order entry, ePrescribing systems and wireless device integration...

BACKGROUND: Dietitians increasingly interact with electronic health records (EHRs) and use them to alert prescribers to medication inaccuracies. OBJECTIVE: To understand renal dietitians' use of electronic prescribing systems and influence on medication accuracy in inpatients. In outpatients to determine whether renal dietitians' use of the electronic medication recording might improve accuracy. METHODS: In inpatients we studied the impact of dietetic advice on medical prescribing before and after moving from paper recommendations to ePrescribing...

Objective The transition to digital hospitals is fast-moving. Although US hospitals are further ahead than some others in implementing eHealth technologies, their early experiences are not necessarily generalisable to contemporary healthcare because both the systems and technologies have been rapidly evolving. It is important to provide up-to-date assessments of the evidence available. The aim of this paper is to provide an assessment of the current literature on the effects to be expected from hospital implementations of eHealth technologies...